Decreased Medial Prefrontal Cortex Glutamate Levels in Perimenopausal Women

Sidney Yap; Jessica Luki; Christopher C Hanstock; Peter Seres; Tami Shandro; Sarah E C Hanstock; Alynna Lirette; Huaying Helen Zhao; Katherine J Aitchison; Jean-Michel Le Melledo

doi:10.3389/fpsyt.2021.763562

Decreased Medial Prefrontal Cortex Glutamate Levels in Perimenopausal Women

Front Psychiatry. 2021 Dec 13:12:763562. doi: 10.3389/fpsyt.2021.763562. eCollection 2021.

Authors

Affiliations

¹ Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.
² Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada.
³ Lois Hole Hospital for Women, Royal Alexandra Hospital, Edmonton, AB, Canada.
⁴ Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada.
⁵ The Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada.
⁶ Edmonton Mood and Anxiety Disorders Program, University of Alberta Hospital, Edmonton, AB, Canada.

Abstract

Objective: There is an increased risk of experiencing depression during perimenopause (PM), a period of rapidly changing female hormone concentrations. Women at particular risk of developing major depression (MD) during PM are those with history of mood sensitivity to female hormone fluctuations i.e., women with a history of premenstrual dysphoric disorder (PMDD) and/or post-partum depression (PPD). Depressive symptomology has been associated with fluctuations of glutamate (Glu) levels in the medial prefrontal cortex (MPFC) in MD patients as well as PMDD and PPD patients. The objective of the study was to compare MPFC Glu levels in healthy perimenopausal and reproductive-aged (RD) women. Methods: Medial prefrontal cortex Glu levels in healthy perimenopausal (n = 15) and healthy RD women (n = 16) were compared via Magnetic Resonance Spectroscopy (MRS) scan using a 3 Tesla (T) magnet. Absence of depressive symptomology and psychiatric comorbidity was confirmed via semi-structured interview. Participants were scanned during the early follicular phase (FP) of the menstrual cycle (MC). Results: Mean MPFC Glu concentrations were decreased in the PM group compared to RD group (PM mean = 0.57 ± 0.03, RD mean = 0.63 ± 0.06, t = -3.84, df = 23.97, p = 0.001). Conclusion: Perimenopause is associated with decreases in MPFC Glu levels. This decrease may be contributing to the increased risk of experiencing depression during PM. Further research should assess MPFC Glu levels in perimenopausal women suffering from MD.

Keywords: depression; glutamate; magnetic resonance spectroscopy - MRS; medial prefrontal cortex; perimenopause.